Years In Daily Practice Research Articles

Safety during medical waste transport in practice

Purpose: The aim of the article is to provide objective information about the classification of medical waste and its storage and transport based on the Silesian waste transport company – Ekomed. Generally, waste is very marginalized by society, therefore the article aims to present the further way of dealing with medical waste. Design/methodology/approach: The basic research methods were the analysis of literature on the safety of transport of medical waste, along with their categorization based on the BDO system, by example of Silesian waste transport company – EKOMED. Findings: Disposing of medical or chemical waste is a unique responsibility. Leaving such a sensitive procedure to the wrong companies or people who do not have adequate technical and personal resources may not only have dangerous consequences, but also be severely punished by applicable law. Therefore, it is worth trusting certified companies that not only have many years of experience, but also perfectly understand the responsibility of waste producers. Research limitations/implications: In the future, research will be continued in the field of medical waste transport in context of safety, especially during pandemic. Practical implications: This article provides an overview of quantitative research and diversity of medical waste from medical facilities in Poland. This review shows the importance and scale of the problem and allows for further continuation of research to manage the generated waste. The author has also noted that people generally forget about waste when they get into the bin. The main aim is to get people’s attention what is happening later with the medical waste. Originality/value: Based on empirical research, the article shows the scale of the problem that, through the new EU directives on the recycling and sustainable development, will be a forward- looking and important issue. Additionally, the article presents concepts for medical waste transport based on a Silesian company EKOMED. It’s twenty years of daily practice of transporting medical waste to the place of its disposal allowed the development of effective logistic solutions for its safe transport, which turned out to be of invaluable value during the SARS-COV-2 virus pandemic. Keywords: medical waste, transport, safety. Category of the paper: Research paper.

Maintenance to target was associated with radiological outcomes in patients with rheumatoid arthritis: a real-world observational cohort study.

To investigate the effect of different maintenance to target on radiologic outcomes in patients with rheumatoid arthritis (RA) in real-world setting. RA patients enrolled were screened from a longitudinal cohort. The radiographies were evaluated at baseline, after 1-2 years and thereafter every 2 years. An increase of mTSS > 3 from baseline was taken as the primary outcome and accelerated annual radiological progression as the secondary outcome of radiological progression. The maintenance rate (MR) to target was calculated as the proportion of the year fulfilling preset criteria of target over the whole follow-up period. COX regression and logistic analysis were used to determine the effect of variables on radiological outcomes. Two hundred forty-three patients were enrolled, with median follow-up of 2 years (3.00). Radiological progression was observed in 43 (17.7%) patients, with annual increase of mTSS 0.20 (1.33). In multivariate analysis, MR was the only independent protective factor of both primary and secondary radiological outcomes in two models [HR 0.09, 95% CI (0.04, 0.22), p < 0.001, model 1; OR 0.21, 95% CI (0.09, 0.49), p < 0.001, model 2]. ACPA positivity was another independent risk factor of secondary outcome [OR 2.96, 95% CI (1.27, 6.86), p = 0.012]. Higher MR was also associated with less radiological progression in established RA patients. Partial MR was not inferior to full maintenance within 4 years in terms of halting radiological progression. Low MR and ACPA positivity were independent risk factors of poor radiological outcomes in RA patients. No significant difference in radiological progression could be detected between partial and full maintenance group within 4 years in daily practice. • The first study showing that maintenance to target is beneficial to bone protection in established RA patients in real-world setting • No difference in radiological outcomes between partial and full maintenance group within 4 years.

Differences in practice behaviours between expert musicians and non-musicians when learning a basic surgical skill

Background: Researchers have hypothesized that years of daily practice on a musical instrument may lead to increased efficiency in practice behaviours during the learning of other fine motor skills [1]. Practice strategies in music have also been considered a suitable model for surgical training [2] and some believe that surgical outcomes might be improved by adopting musicians’ practice strategies [3].Objective: This study examines the practice behaviours of expert musicians attempting to learn a basic surgical skill, as a way to detect possible transfer of practice habits across domains. This paper investigates whether musicians differ from a control group in their selection and application of practice strategies, whether there are relationships between the choice of practice behaviours and performance scores, whether musicians progress more rapidly through the different phases of learning and, whether relationships exist between those who reach automaticity sooner and their choice of practice behaviours.Methods: Participants’ practice sessions during a knot-tying task (taught via instructional video) were video-recorded and treated according to the method of thematic analysis [4]. Coding was performed by two evaluators through an iterative process and statistical and descriptive analyses were conducted on practice behaviours. Information was also collected on instructional video navigation so that the use of replay, pause, rewind or fast-forward could be investigated.Results: Musicians and the control group participants favoured different practice behaviours; this was demonstrated in their choice of strategies, the importance they gave to each strategy, and the way they used the strategies over the two practice sessions. There was evidence that the group of expert musicians applied better practice strategies as the choice of practice behaviours correlated positively with performance scores and their capacity to reach automaticity.Conclusion: Our results suggest that music experts may be applying practice strategies developed during their music studies when learning a novel surgical skill. This raised the possibility that practice skills developed through years of dedicated work at their musical instrument, might be transferable when learning a motor skill in a different domain.

SCIT with a high-dose house dust mite allergoid is well tolerated: safety data from pooled clinical trials and more than 10 years of daily practice analyzed in different subgroups

BackgroundEfficacy of house dust mite (HDM) allergen immunotherapy (AIT) in allergic rhinitis and controlled allergic asthma has been documented in controlled trials with adults and children. However, tolerability comparing clinical development and post marketing data, particularly in different subgroups, is missing.MethodsWe performed an analysis of pooled safety data for subcutaneous AIT (SCIT) with a high-dose house dust mite allergoid from 6 randomized, controlled trials (RCT) in HDM allergic respiratory disease (ARD) and of post marketing safety data from more than 10 years including different subgroups (age, gender, asthma status).ResultsIn all, 500 patients with ARD were treated in RCTs: 279 received the marketed dose of 1800 protein nitrogen units (PNU) high-dose HDM allergoid AIT (214 double-blind placebo controlled [HDM-DBPC], 65 children/adolescents usual care controlled [HDM-RCT(UC)]), and 221 placebo (PL). 38.8% adverse events (AEs) were observed with 1800 PNU in HDM-DBPC (31.2% PL, 35.5% HDM-ALL [1800 PNU]); the difference was primarily because of local reactions; there was no difference in systemic reactions (10.9% PL, 11.2% HDM-DBPC, 11.2% HDM-ALL); one out of 279 high-dose HDM allergoid-treated patients had a serious adverse event (SAE).Children (n = 39)/adolescents (n = 26) had fewer related AEs and local reactions compared to adults; systemic reactions: children 12.8%, adults 11.2% adolescents 7.7%. Females had slightly more AEs. Treatment was well tolerated in asthmatic patients (n = 267; GINA I n = 32, II n = 104, III n = 17, 114 no classification).In more than 10 years more than 100,000 patients were treated with high-dose HDM allergoid (1800 PNU) under daily practice conditions. Adverse drug reactions (ADRs) were reported in 0.5% of patients. 94.6% of these ADRs were expected.ConclusionSCIT with the marketed dose of high-dose HDM allergoid was well tolerated in clinical development and in daily practice. There was no increased risk for the investigated patient subgroups. Tolerability was comparable to HDM sublingual immunotherapy (SLIT) tablets.

Source Memory and Cognitive Control in Gurdjieff Meditators

Several studies have been conducted to investigate the influence of meditation on cognition. Little is known, however, about the potential effects of meditation on episodic memory performance. In order to address this issue, we recruited 38 participants with a minimum of 5 years of daily practice of Gurdjieff meditation, and 38 participants matched for age and education, who had never practiced meditation. All participants performed two memory tasks, namely, the Rey complex figure test, and a source memory task in which they saw figures of objects on the left or right side of a computer screen, and had later to indicate the side wherein each object was previously seen. Attention and working memory capacities were also examined. The current data shows that Gurdjieff meditators present greater working memory performance than non-meditators. The two groups, however, show identical performance in both memory tasks. Thus, although the current results give further support for the notion that meditation is beneficial to working memory performance, no evidence was found suggesting that such benefits are extended to episodic memory performance.

Animating human dressing

Dressing is one of the most common activities in human society. Perfecting the skill of dressing can take an average child three to four years of daily practice. The challenge is primarily due to the combined difficulty of coordinating different body parts and manipulating soft and deformable objects (clothes). We present a technique to synthesize human dressing by controlling a human character to put on an article of simulated clothing. We identify a set of primitive actions which account for the vast majority of motions observed in human dressing. These primitive actions can be assembled into a variety of motion sequences for dressing different garments with different styles. Exploiting both feed-forward and feedback control mechanisms, we develop a dressing controller to handle each of the primitive actions. The controller plans a path to achieve the action goal while making constant adjustments locally based on the current state of the simulated cloth when necessary. We demonstrate that our framework is versatile and able to animate dressing with different clothing types including a jacket, a pair of shorts, a robe, and a vest. Our controller is also robust to different cloth mesh resolutions which can cause the cloth simulator to generate significantly different cloth motions. In addition, we show that the same controller can be extended to assistive dressing.

Saying 'Om' Instead of 'Ow'

![Figure][1] CREDIT: ROBERT WALLIS/CORBIS The pain-relieving benefits of meditation aren't merely in people's minds but in their brains, too, according to a new study. Neuroscientists at the University of Montreal in Canada turned up the heat on a metal cube applied to the legs of 17 male and female Zen meditation practitioners between the ages of 22 and 57, and 18 matched controls. On average, the meditators, who had between 2 and 30 years of daily practice, tolerated an extra 2°C before saying they were in moderate pain. The team then took MRI scans of the subjects and measured the thickness of certain pain-processing regions in the cerebral cortex. The meditators had greater thickness in a region of the anterior cingulate cortex (ACC), an area thought to mediate pain's unpleasantness. Thicker ACCs were also correlated with less sensitivity to pain in the leg test, the team reported last month in the journal Emotion . The study's lead author, Joshua Grant, says that although physical activities are known to change brains, “I don't know if it's ever been shown that a mental activity—placing your attention on something”—can cause physical changes in that organ. The study “demonstrates convincingly the impact of meditation practice on pain perception,” says Bogdan Draganksi, a neuroscientist at University College London. “The idea of training the ‘emotional muscle’ … is very tempting.” [1]: pending:yes

Practical Advice to the Beginner in Hair Transplantation

Daily practice of hair transplantation enables one to develop certain personal techniques that help to facilitate operations. Such techniques, acquired during 22 years of daily practice, are presented.

Tai Chi and ankylosing spondylitis--a personal experience.

On the suggestion of a Chinese physician the author took up Tai Chi, a traditional Chinese exercise, in an attempt to relieve symptoms from his moderately severe ankylosing spondylitis. Conventional medical therapy, used over a 15 year period, had proven of only limited benefit. Tai Chi consists of a series of intricate exercise sequences, and after 2 1/2 years of daily practice the author now feels stronger and healthier than before. Pain, weakness and general malaise return if practice is neglected for as little as one week. It is felt that Tai Chi is of value in minimizing the flexion deformity of the spine. Improved skeletal muscle strength, limb co-ordination, balance, chest movement and ability to relax are further benefits.